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March 1959

External Laryngocele

AMA Arch Surg. 1959;78(3):422-424. doi:10.1001/archsurg.1959.04320030066012

Laryngocele is a rare and interesting swelling of the neck. It is almost never mentioned in the differential diagnosis of cervical masses. The diagnosis is relatively simple if the entity is kept in mind.

Between the true and the false vocal cords is an elliptical, horizontal space, called the ventricle of Morgagni. Anteriorly, from the roof of the ventricle, arises an outpouching called the sacculus, or appendix. This structure may be only a shallow pouch or may extend as a long narrow prolongation as high as the superior edge of the thyroid cartilage, or even the hyoid bone (Fig. 1). In this latter situation, the sphincteric action of the thyroarytenoid muscles is lacking,6 and during any action which produces repeated elevation of intralaryngeal pressure (chronic coughing, straining, wind-instrument playing, etc.) the pressure is transmitted to the sacculus, which may dilate to form a laryngocele.

As the sacculus dilates, it